Analysis of Human Milk Composition After Preterm Delivery With and Without Fortification

Human milk is often assumed to have a consistent composition, and when fortification is needed, fortifiers are added at fixed doses. However, if the milk contains less than the assumed quantities of nutrients, then the infant drinking that milk may receive inadequate nutrition. In this study, we compared changes in the concentrations of the main constituents of human breast milk before and after fortification. We tested the hypothesis that the protein concentration would increase less than that of other nutrients. Thirty breast milk samples were obtained from mothers of preterm infants (gestational age 28-36 weeks; birthweight 900-2,470 g). The concentrations of fat, carbohydrates, dry matter, protein and energy in the breast milk samples were analyzed and compared with the concentrations of these nutrients in the same samples of milk fortified with a standard amount of HMF FM 85. Dry matter and energy content increased the most after fortification. Although protein also increased, the magnitude of this increase was small relative to the increases in the other components. Lipid concentrations did not significantly change with fortification. Protein is needed for adequate growth in premature infants; however, fortification of breast milk from the mothers of preterm infants resulted in only a small increase in this essential nutrient. Based on these results, we conclude that fortification of human milk must be individually adjusted based on continuous analysis of breast milk composition. Customized fortification would provide more optimal nutrition to preterm infants to support better growth and development.